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Professional Perspectives on Mental Distress : Exploring Attributional Differences and Their Association With Stigmatizing Attitudes Among Psychiatrists, Psychologists, and Social Workers

Wolgast, Martin LU ; Tham, Katarina Fredriksson ; Straht, Maja and Levinsson, Henrik LU (2025) In International Journal of Social Psychiatry
Abstract

Background: Mental health professionals often differ in their explanatory models of mental distress, which may influence their attitudes toward individuals experiencing such conditions. Stigmatizing attitudes among providers can adversely affect therapeutic relationships, service quality, and recovery outcomes. Aims: This study investigates the attributional frameworks—biological, cognitive-behavioral, psychodynamic, and social-realist—endorsed by psychiatrists, psychologists, and social workers in Swedish adult psychiatry. It further examines how these explanatory preferences are associated with stigmatizing attitudes toward individuals with mental distress. Method: A cross-sectional survey was conducted with 715 licensed... (More)

Background: Mental health professionals often differ in their explanatory models of mental distress, which may influence their attitudes toward individuals experiencing such conditions. Stigmatizing attitudes among providers can adversely affect therapeutic relationships, service quality, and recovery outcomes. Aims: This study investigates the attributional frameworks—biological, cognitive-behavioral, psychodynamic, and social-realist—endorsed by psychiatrists, psychologists, and social workers in Swedish adult psychiatry. It further examines how these explanatory preferences are associated with stigmatizing attitudes toward individuals with mental distress. Method: A cross-sectional survey was conducted with 715 licensed psychiatrists, psychologists, and social workers. Attributional orientations were measured using a revised version of the Maudsley Attitude Questionnaire (MAQ-R), and stigma was assessed with the revised Opening Minds Stigma Scale for Health Care Providers (OMS-HC-R). Group differences were analyzed using General Linear Models, and associations between attributional frameworks and stigma were explored through linear regression. Given the cross-sectional design, causal inferences cannot be drawn from the observed associations. Results: Psychiatrists reported significantly stronger endorsement of biological attributions compared to psychologists and social workers, while psychologists favored cognitive-behavioral and psychodynamic explanations. Social workers exhibited the strongest preference for social-realist attributions. Endorsement of biological and cognitive-behavioral models was positively associated with higher stigma scores, although these associations may reflect broader occupational or systemic influences. In contrast, social-realist attributions were associated with lower stigma. Psychodynamic attributions showed no significant association. Conclusions: Differences in attributional frameworks among mental health professionals are associated with variation in reported stigmatizing attitudes. These findings underscore the importance of addressing explanatory diversity in interdisciplinary training and suggest that nuanced understandings of etiology may inform stigma-reduction efforts. Future research should explore the role of contextual and institutional factors, as well as potential confounders, in shaping these relationships.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
attributional frameworks, biological models, cognitive-behavioral models, interdisciplinary care, mental health professionals, social-realist perspectives, stigmatizing attitudes
in
International Journal of Social Psychiatry
article number
00207640251383193
publisher
SAGE Publications
external identifiers
  • pmid:41185127
  • scopus:105020763519
ISSN
0020-7640
DOI
10.1177/00207640251383193
language
English
LU publication?
yes
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Publisher Copyright: © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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date added to LUP
2026-01-14 09:59:23
date last changed
2026-01-15 03:00:15
@article{aa4be72c-d17a-4912-addc-bf301d837a5b,
  abstract     = {{<p>Background: Mental health professionals often differ in their explanatory models of mental distress, which may influence their attitudes toward individuals experiencing such conditions. Stigmatizing attitudes among providers can adversely affect therapeutic relationships, service quality, and recovery outcomes. Aims: This study investigates the attributional frameworks—biological, cognitive-behavioral, psychodynamic, and social-realist—endorsed by psychiatrists, psychologists, and social workers in Swedish adult psychiatry. It further examines how these explanatory preferences are associated with stigmatizing attitudes toward individuals with mental distress. Method: A cross-sectional survey was conducted with 715 licensed psychiatrists, psychologists, and social workers. Attributional orientations were measured using a revised version of the Maudsley Attitude Questionnaire (MAQ-R), and stigma was assessed with the revised Opening Minds Stigma Scale for Health Care Providers (OMS-HC-R). Group differences were analyzed using General Linear Models, and associations between attributional frameworks and stigma were explored through linear regression. Given the cross-sectional design, causal inferences cannot be drawn from the observed associations. Results: Psychiatrists reported significantly stronger endorsement of biological attributions compared to psychologists and social workers, while psychologists favored cognitive-behavioral and psychodynamic explanations. Social workers exhibited the strongest preference for social-realist attributions. Endorsement of biological and cognitive-behavioral models was positively associated with higher stigma scores, although these associations may reflect broader occupational or systemic influences. In contrast, social-realist attributions were associated with lower stigma. Psychodynamic attributions showed no significant association. Conclusions: Differences in attributional frameworks among mental health professionals are associated with variation in reported stigmatizing attitudes. These findings underscore the importance of addressing explanatory diversity in interdisciplinary training and suggest that nuanced understandings of etiology may inform stigma-reduction efforts. Future research should explore the role of contextual and institutional factors, as well as potential confounders, in shaping these relationships.</p>}},
  author       = {{Wolgast, Martin and Tham, Katarina Fredriksson and Straht, Maja and Levinsson, Henrik}},
  issn         = {{0020-7640}},
  keywords     = {{attributional frameworks; biological models; cognitive-behavioral models; interdisciplinary care; mental health professionals; social-realist perspectives; stigmatizing attitudes}},
  language     = {{eng}},
  publisher    = {{SAGE Publications}},
  series       = {{International Journal of Social Psychiatry}},
  title        = {{Professional Perspectives on Mental Distress : Exploring Attributional Differences and Their Association With Stigmatizing Attitudes Among Psychiatrists, Psychologists, and Social Workers}},
  url          = {{http://dx.doi.org/10.1177/00207640251383193}},
  doi          = {{10.1177/00207640251383193}},
  year         = {{2025}},
}